Influence of Renal Excretory Function on the Performance of Urine Based Markers to Detect Bladder Cancer

Todenhöfer, Tilman; Hennenlotter, Jörg; Witstruk, M.; Gakis, Georgios; Aufderklamm, Stefan; Kuehs, Ursula; Stenzl, Arnulf; Schwentner, Christian

doi:10.1016/j.juro.2011.09.023

Cited by 22 publications

(42 citation statements)

References 29 publications

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“…No significant correlation between other potential modifying factors such as serum creatinine/glomerular filtration rate, 8 degree of proteinuria, 20 microscopic hematuria, 11 and leukocyturia 11 could be demonstrated. The reasons for this are multiple overlapping conditions in this patient population.…”

Section: Discussionmentioning

confidence: 89%

“…Urine markers including the NMP22 test are gaining importance for primary diagnosis and in the tumor follow-up. 8 The NMP22 test is an accepted screening test/ method for "general patient population" with acceptable sensitivity and specificity. However, as described by others, the NMP22 test has inherent limitations, which must be considered.…”

Section: Discussionmentioning

confidence: 99%

“…However, as described by others, the NMP22 test has inherent limitations, which must be considered. 8,11,19 In this study, the NMP22 test was used in a highly selected patient population with ESRD to screen for potential "malignancies of the urinary tract (transitional cell cancer)". Patients with ESRD are a subpopulation of patients with microscopic hematuria.…”

Section: Discussionmentioning

confidence: 99%

“…7 Recent publications have reported an increasing falsepositive rate of the nuclear matrix protein-22 (NMP22) test depending on renal function. 8 NMP22 is a protein involved in regulation of mitosis and is overexpressed in malignant urothelial cells. Apoptotic cells release NMP22 into the urine, where it can be detected and quantified.…”

Section: Introductionmentioning

confidence: 99%

“…The authors recommended that renal function should be considered when urine-based bladder cancer tests are interpreted. 8 Therefore, we report in a retrospective fashion our findings regarding the usefulness/accuracy of the NMP22 test in the context of a transplant workup in patients with ESRD and microscopic hematuria.…”

Section: Introductionmentioning

confidence: 99%

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The Clinical Usefulness of Nuclear Matrix Protein-22 in Patients with End-Stage Renal Disease and Microscopic Hematuria

et al. 2012

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Objectives: To evaluate the sensitivity, specificity, and false-positive rate of the nuclear matrix protein-22 (NMP22) test in patients with end-stage renal disease (ESRD) and microscopic hematuria in order to avoid unnecessary follow-up tests for patients with false-positive NMP22 test results. Patients and Methods: Patients with ESRD were screened for microscopic hematuria as part of the pre-transplant workup. Patients with documented microscopic hematuria underwent workup as recommended by the American Urological Association. Results: Between January 2006 and April 2012, 277 patients with ESRD were referred to the Department of Urology for pre-transplant evaluation. Fifty-seven (22.6%) patients were found to have microscopic hematuria and underwent further testing. Nineteen (33.3%) patients demonstrated a positive NMP22 test result and 38 (66.7%) had a negative NMP22 test result. The false-positive rate was 32.7%. The sensitivity and specificity of the NMP22 test in this patient population were 50% and 67%, respectively. The positive predictive value of the test was 52.6% and the negative predictive value 97.3%. Especially noteworthy, the two detected transitional cell cancers of the urinary bladder were both demonstrated during cystoscopy, independent of their NMP22 or urine cytology test result. Conclusions: Our study revealed a significantly increased NMP22 test false-positive rate, low sensitivity, and specificity in the setting of high prevalence of microscopic hematuria, proteinuria, and low glomerular filtration rate in patients with ESRD. Therefore, cystoscopy remains the gold standard for patients with ESRD and microscopic hematuria for pre-transplant evaluation.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Clinical Usefulness of Nuclear Matrix Protein-22 in Patients with End-Stage Renal Disease and Microscopic Hematuria

et al. 2012

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Utility of urinary biomarkers in primary haematuria: Systematic review and meta‐analysis

et al. 2022

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Objectives To evaluate the diagnostic performance of FDA‐approved urinary biomarkers in the evaluation of primary haematuria for investigation of bladder cancer. Methods The scientific databases MEDLINE, EMBASE, Pubmed and Web of Science were searched to collect studies. Studies that evaluated the diagnostic performance of FDA‐approved urinary biomarkers in investigating patients with primary haematuria without a prior history of bladder cancer were included. Quality of studies was assessed using the JBI Criteria. Bivariate mixed‐effects regression model was used to calculate pooled sensitivities and specificities for each biomarker. Results Eighteen studies were included in the analysis. The biomarkers assessed in these studies were CxBladder, AssureMDx, Bladder Tumour Antigen (BTA), NMP22, UroVysion and Immunocyt/uCyt+. Several biomarkers, such as AssureMDx, CxBladder and Immunocyt, were shown to have better diagnostic performance based on their sensitivity, specificity and diagnostic odds ratio, as well as positive and negative likelihood ratios. Across the six biomarkers, sensitivity ranged from 0.659 to 0.973, and the specificity ranged between 0.577 and 0.833. Conclusion Despite certain biomarkers demonstrated better performance, current diagnostic abilities of the FDA‐approved biomarkers remain insufficient for their general application as a rule out test for bladder cancer diagnosis and as a triage test for cystoscopy in patients with primary haematuria. High‐quality prospective studies are required to further analyse this and also analyse the correct scenario in which urinary biomarkers may be best utilised.

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Combined application of cytology and molecular urine markers to improve the detection of urothelial carcinoma

Todenhöfer

Hennenlotter

Esser

et al. 2012

Cancer Cytopathology

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BACKGROUND:The sensitivity of cytology for the detection of urothelial carcinoma (UC) is limited. Newer methods such as fluorescence in situ hybridization (FISH), immunocytology (uCytþ), and protein markers have been developed to improve urine-based detection of UC. As only little is known regarding the combined application of these markers, we investigated whether combinations of 4 of the most broadly available tests (cytology, FISH, uCytþ, and nuclear matrix

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Influence of Renal Excretory Function on the Performance of Urine Based Markers to Detect Bladder Cancer

Cited by 22 publications

References 29 publications

The Clinical Usefulness of Nuclear Matrix Protein-22 in Patients with End-Stage Renal Disease and Microscopic Hematuria

The Clinical Usefulness of Nuclear Matrix Protein-22 in Patients with End-Stage Renal Disease and Microscopic Hematuria

Utility of urinary biomarkers in primary haematuria: Systematic review and meta‐analysis

Combined application of cytology and molecular urine markers to improve the detection of urothelial carcinoma

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